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Contraception Maternity Flashcards

1
Q

*

What is access to contraception

A

increased education
reduction in morbidity/mortality
reduction of stress
prevention of unsafe abortions

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2
Q

Which contraceptive method is best/effective?

A

Pt has:
access
afford
tolerate
consistency

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3
Q

What contraceptive can prevent pregnancy and infection

A

condoms

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4
Q

How can the patient be helped to find the right method of contraceptives

A
  1. partner awareness
  2. touching body
  3. desire of pregnancy (within 3 yrs)
  4. Devastation of getting pregnant (within 3 yrs)
  5. drive, location of provider
  6. insurance
  7. Family desire/done
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5
Q

How do Hormonal Methods work

A

suppress ovulation
thicken cervical mucus
thining uterine lining

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6
Q

What are types of hormonal methods

A

pill
patch
shots
ring
impants

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7
Q

What are the disadvantaged of hormonal method

A

prescription needed
not effective against STI

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8
Q

What are side effects of hormonal methods

A

nausea
breast tenderness
mood swings
headache
irregular bleeding (progestin)
weight gain

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9
Q

What are adverse effects of hormonal methods

A

Blood Clotting

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10
Q

What are contraindications of hormonal methods

A

migraine
hypertension
hx of DVT
hx of PE
hx of Stroke
smokers over 38
breastfeeding mothers

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11
Q

What are combined oral contraceptive pills

A

21 hormone contains, 7 placebo pills
seasonal
help with PCOS , cramping, and heavy menstrual bleeding
missed doses: take as soon as possible

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12
Q

what are progestin only pills (POPs)

A

contain only profestin
safe for breastfeeding mother
3 hr window for effectiveness

28 pills

side effect: less regular period, more breakthrough bleeding
ectopic preganany (slow cilia in fallopian tube)

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13
Q

Hormone containing birth control

what is a contraceptive ring

nuva rung, annovera

A

Flexible silicone ring impregnated with estrogen and progestin
not great method for women not touching their bodies

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14
Q

how is a contraceptive ring inserted/used

A
  1. place ring inside vaginal for 3 wks
  2. remove for 1 wk for withdrawl bleeding

can be removed during intercourse
left out upto 3 hrs per day
always check ring after bowel movement

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15
Q

Hormonal Containing Birth Control

Contraceptive Patch

Twirla, Ortho-Evra

A

Patch with estrogen/progestin
less effective BMI>30
not for breastfeeding mother

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16
Q

How is contraceptive patch used?

A
  1. applied weekly for 3 wks
  2. follow by patch-free week cause withdrawl bleed
  3. rotate site weekly=avoid skin irritation
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17
Q

Hormone containing birth control

Contraceptive Injection

Depo Provera

A

**Depo Provera is progestin-only injection **
weight gain concerns
breastfeeding mothers can use (diminish milk production)

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18
Q

How does contraceptive injection work

A

given every 13 weeks until pregnancy desire
start 7 days within last menstural period

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19
Q

Hormone Containing Birth Control

Contraceptive Implant

LARC

A

4cm rod of non-estrogen ethonegestrel under skin of inner upper arm
unschedule bleeding
difficult removal leaves scars

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20
Q

What are benifts of contraceptive implant

A
  • 3 yr approval
  • no user error
    *ovulation within month of removal
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21
Q

Hormone-containing birth control

Emergency Contraception

Plan B and Ella

A

medication or copper intrauterine contraception
effective >165lbs

22
Q

Hormone-containing birth control

Emergency contraception: Levonrgestrel (Plan B)

prevents ovulation

A
  • over counter
  • prescription
  • **taken within 72 hrs **
23
Q

Hormone-containing birth control

Emergency Contraception: Ulipristal (Ella)

A
  • available prescription only
  • 120 hrs
  • progestin blocker, affect exsisting pregnany
24
Q

What are Intrauterine Devices (IUD)

LARCs with/without hormones

A

Copper (paragrad)
Progestin Releasing (mirena & Skylar)
* T shaped

25
How do IUD work
1. thinning lining uterus 2. not good environmen for sperm 3. doesn't interrupt preganncy or cause abortion
26
What are IUD advantages
* no user error *** reversable ** * Long acting | Skyla = 3 yrs Mirena = 5 yrs Paragard = 10 yrs
27
What are disadvantages of IUD
* expensive * inserted by licensed provider * check string placement monthly * paragard heavy bleeding * mirena/skyla ammenorrhea * screening of STI
28
What are types of genetic disorders
* inherited disorder * autosomal recessive * aurosomal dominant * X-linked | Trisomies/MOnosomies/deNovo Mutation = genetic mistake
29
Who should be referred to genetic counseling
1. advanced age (mom>35 & dad>45) 2. family hx 3. poor obstetric outcome 4. infertility 5. positive prenatal screenig 6. certain ethnicities 7. consanguinity (second counsins/closer)
30
# Genetic testing Karyotype of parents
Blood sample
31
# Genetic Testing Non-invasive prenatal sceening (NIPS)
Maternal serum
32
# Genetic Testing Chronic Villus Sampling (CVS)
tissue from chorion side of placenta 10-12 wweeks gestation
33
# Geneic testing Amniocentesis
15 to 20 weeks reprt bleeding or cramping
34
# Preconception who should preconceptual health care be provided to
anyone child barrier | chronic disease modifiable/non-modifiable poor obstetric outcomes
35
36
# Preconception Healh What are simple quesion to ask for preconception counseling
* planning to become pregnant * planning to emark on journey
37
# Female Reproductive What is the Ovarian cycle
process of oocye develepment, release, hormonal, prep for implantaition of fertilized ovum
38
# female reproductive what is the uterine cycle
development of uterine lining receiving and sustaining fertilized ovum
39
# Fertility What lifestyle factors can impair fertility
1. weight: underweight halt ovulation, obesity impairs fertility 2. smoking 3. males drug use 4. sexual transmitted disease 5. stress physical and emotional
40
what is inferility
lack of pregancy of 12 months of well-timed intercours spontaneous abortion
41
# Fertility What is the female evaluation
* menstrual hx * urine testing * serum follical stiumulating hormole * thyroid stimulating hormone
42
# fertility what is the evaluation for male
* semen analysis * semen volume/pH * sperm concentration, motility, morphology * sperm leukocyte * immature germ cells
43
# Fertility Treatment Clomiphene
**clomiphene citrate is selective estrogen receptor modulator to induce ovulation** * start 5 days after start of mensturation * risk miscarrage, ectopic, spontaneous pregnancies * risk of multiple gestations
44
# Fertility Treatment Human Menopausal Gonadotropin | pergonal
**IM injection daily until US reveals mature ovarian follicle** * stimulates ovaries * intercourse everyother day for 1 week starting 5th day * multiple office visists
45
what are risks for human menopausal gonadotropin
* risk of ovarian hyperstimulation * risk of multiple gestation (twin gestation)
46
# fertility treatment Artificial Reproductive Technology (ART)
**IUI: Intauterine Insemination** **IVF: Vitro Fertilization**
47
# ART What is Intrauterine Insemination
Sperm washed and introduced into upper uterine cavity
48
# ART What is Vitro Fertilization
treat infertility due to tubal, severe male, uterine, ovarian facotrs * ovarain stimulated/eggs retrieved by ultrasound and mixed with cleaned sperm * identified after 17 hrs of transpalnt into uterus or frozen
49
# ART What is Gamete Intrafallopain Transfer
sperm and eggs combined then placed in fallopian tube for fertilization via laparoscopy (general anesthesia)
50
# ART What is Intracytoplasmic sperm injection
sperm retreived from epidiymis using needle through skin, single sperm cell isolated and injected into an egg
51
# ART what are alternative and complementary therapies
1. acupuncture 2. herbal meds 3. yoga 4. body works 5. dietary changes 6. prayer
52
# Infertility Therapy what is the Nursing role
1. teach about meds/procedure/timing of intercours/risk of self-infection 2. emotional support

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